Emesis

Question 1

What is emesis?

Answer 1

Also called vomiting, it is the involuntary, forceful expulsion of the content of the stomach through the mouth and sometimes nose.

Question 2

What is regurgitation?

Answer 2

The voluntary return of undigested food from the stomach to the mouth for further mastication.

Question 3

What are the phases of emesis?

Answer 3

• Nausea
• Retching
• Expulsion
• Recovery

Question 4

What is faecal emesis?

Answer 4

It is a phenomenon involving the expulsion of faecal matter into the stomach from the large intestines then through the mouth.

Question 5

Faecal emesis is also called ________.

Answer 5

Copremesis
Stercoraceous vomiting
Miserere

Question 6

Mention 15 causes of emesis.

Answer 6

• Specific response to ailment
  1. Gastritis
  2. Poisoning

-Nonspecific sequelae
3. Brain tumor
4. Appendicitis
5. Concussion
6. Migraine
7. Iodizing radiation
8. Motion sickness
9. Meniere’s disease
10. Elevated intracranial pressure

• Drug reactions
  11. Alcohol
  12. Chemotherapy
  13. Entheogens
  14. Opioids
  15. Serotonin reuptake inhibitors
• Metabolic Disturbances
  16. Hypercalcemia
  17. Hypoglycemia
  Adrenal insufficiency
  18. Uremia
• Other causes
  19. Pregnancy
  20. Disagreeable sight/smell
  21. Binge eating
  22. Post operation
  23. Violent fits of cough, hiccup, asthma

Question 7

What are underlying medical conditions associated with faecal vomiting?

Answer 7

i. Intestinal obstruction
ii. Gastrocolic fistula
iii. Sever GI infections e.g. Clostridium difficile colitis

Question 8

What are the symptoms of faecal emesis?

Answer 8

i. Vomiting faeces
ii. Abdominal pain
iii. Nausea
iv. Dehydration
v. Fever

Question 9

What are the complications of emesis?

Answer 9

i. Aspiration of vomit
ii. Electrolyte imbalance
iii. Mallory-Weiss tear
iv. Dental complications

Question 10

As a healthcare professional, how do you respond to emesis?

Answer 10

1. Assess symptoms
   i. Determine the frequency, duration and severity of vomiting
   ii. Assess associated symptoms such as nausea, abdominal pain, fever
   iii. Ask about recent food/drink consumption, travel or exposure to sick individuals.
2. Hydration and electrolyte balance
   i. Frequent vomiting may lead to dehydration and electrolyte imbalance, so encourage individual to drink small sips of clear fluids
   ii. Monitor for signs of dehydration.
3. Dietary Adjustment
   i. Advise clear fluid diet
   ii. Avoid spicy, oily or heavily season foods which may worsen nausea and vomiting
   iii. Gradually reintroduce solids once vomiting subsides

Question 11

Which antiemetic drugs may be used to treat vomiting caused by motion sickness?

Answer 11

i. Diphenhydramine (Benadryl) - AH
ii. Promethazine (Avomine) - AH
iii. Dimenhydrinate (Gravol) - AH
iv. Meclizine (Bonine) - AH

Question 12

Which antiemetic drugs may be used to treat vomiting caused by morning sickness?

Answer 12

i. Vitamin B6
ii. Diphenhydramine (Benadryl) - AH
iii. Promethazine (Avomine) - AH
iv. Prochlorperazine (Compazine) - Antipsychotic

Question 13

Which antiemetic drugs may be used to treat vomiting caused by gastroenteritis?

Answer 13

i. Sodium citrate + dextrose + fructose (Nauzene)
ii. Orthophosphoric acid + fructose + glucose
iii. Bismuth subsalicylate (Pepto Bismol)

Question 14

Which antiemetic drugs may be used to treat vomiting caused by Cancer treatment?

Answer 14

i. Ondansetron (Zofran) - 5-HT3 receptor antagonist
ii. Granisetron (Kytril) - 5-HT3 receptor antagonist
iii. Prochlorperazine (Compazine) - Antipsychotic